Does optimizing Choose to Move - a health-promoting program for older adults - enhance scalability, program implementation and effectiveness?

Background: Investment in scale-up and sustainment of effective health-promoting programs is often hampered by competing demands on scarce health dollars. Thus, optimizing programs to reduce resource use (e.g.

Study protocol for an economic evaluation and budget impact of implementation strategies to support routine provision of antenatal care for gestational weight gain: a stepped-wedge cluster trial.

Background: Antenatal clinical practice guidelines recommend routine assessment of weight and provision of advice on recommended weight gain during pregnancy and referral to additional services when appropriate. However, there are barriers to clinicians adopting such best-practice guidelines. Effective, cost-effective, and affordable implementation strategies are needed to ensure the intended benefits of guidelines are realised.

Cost, cost-consequence and cost-effectiveness evaluation of a practice change intervention to increase routine provision of antenatal care addressing maternal alcohol consumption.

Background: Implementation of antenatal clinical guideline recommendations for addressing maternal alcohol consumption is sub-optimal. There is a complete absence of evidence of the cost and cost-effectiveness of delivering practice change interventions addressing maternal alcohol consumption amongst women accessing maternity services. The study sought to determine the cost, cost-consequence and cost-effectiveness of developing and delivering a multi-strategy practice change intervention in three sectors of a health district in New South Wales, Australia.

How cost-effective is nutrition care delivered in primary healthcare settings? A systematic review of trial-based economic evaluations.

Context: Nutrition care is an effective lifestyle intervention for the treatment and prevention of many noncommunicable diseases. Primary care is a high-value setting in which to provide nutrition care.

Objective: The objective of this review was to evaluate the cost-effectiveness of nutrition care interventions provided in primary care settings.

Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines.

Background: Despite the known benefits of healthy eating in childhood, few Australian childcare services provide food that is consistent with dietary guidelines. The effectiveness of a web-based menu planning intervention to increase childcare service provision of healthy foods and decrease provision of discretionary foods in long day-care services in Australia was assessed in a randomised controlled trial. Here we consider the costs, consequences, cost-effectiveness and budget impact of the intervention using data collected within the trial.

Maternal Diet Quality, Body Mass Index and Resource Use in the Perinatal Period: An Observational Study.

The impact of pre-pregnancy obesity and maternal diet quality on the use of healthcare resources during the perinatal period is underexplored. We assessed the effects of body mass index (BMI) and diet quality on the use of healthcare resources, to identify whether maternal diet quality may be effectively targeted to reduce antenatal heath care resource use, independent of women's BMI. Cross-sectional data and inpatient medical records were gathered from pregnant women attending publicly funded antenatal outpatient clinics in Newcastle, Australia.

Protocol for an economic evaluation and budget impact assessment of a randomised, stepped-wedge controlled trial for practice change support to increase routine provision of antenatal care for maternal alcohol consumption.

Background: Antenatal clinical practice guidelines recommend routine assessment of women's alcohol consumption during pregnancy. The delivery of advice and referral when necessary are also recommended. However, evidence suggests there are barriers to the uptake of best-care guidelines.

Do the Dietary Intakes of Pregnant Women Attending Public Hospital Antenatal Clinics Align with Australian Guide to Healthy Eating Recommendations?

The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW).

A systematic review of economic evaluations of antenatal nutrition and alcohol interventions and their associated implementation interventions.

Context: Improving maternal nutrition and promoting alcohol abstinence during pregnancy are key to reducing subsequent economic and social impacts. However, antenatal nutrition and alcohol interventions are underused, partly because economic evidence to support investment is limited.

Objective: The purpose of this systematic literature review was to assess the extent to which economic evaluations have been applied to antenatal public health interventions, and implementation strategies addressing maternal nutrition and alcohol intake.

Economic Evaluations of Stepped Models of Care for Depression and Anxiety and Associated Implementation Strategies: A Review of Empiric Studies.

Since the mid-2000s stepped care, a model of integrated healthcare delivery, has been promoted for offering accessible, effective and efficient services for individuals with mental health conditions. However, adoption of the model has not been widespread warranting additional investment by way of implementation strategies to encourage uptake. These strategies also require funding and their value for money should be assessed to inform decision making and practice.

[Treatment of anemia in patients after long term hemodialysis with human recombinant erythropoietin].

Clinical effectiveness of recombinant human erythropoietin (Epo) administered subcutaneously (sc) was examined in 19 anemic patients. The patients were given Epo twice weekly 2000 U (67 +/- 12 U/kg/week). The results were compared to the group of 20 patients receiving Epo intravenously (i.

Acute rejection and delayed graft function--risk factors of graft loss.

Acute graft rejection and delayed function are considered to be the major risk factors of short-term as well as long-term graft survival. We studied the impact of these factors on graft outcome among 109 renal transplant recipients. All recipients were treated with triple drug protocol.

[Treatment with human recombinant erythropoietin and nutritional status of patients on lon term dialysis].

Unlabelled: In order to assess the effect of long term erythropoietin (EPO) therapy on the nutritional status of hemodialysed (HD) patients 2 groups of HD patients were studied: I-EPO treated for 72 +/- 8 mo, 12 patients, HD for 138 +/- 66 mo, II-control group, 14 patients with Ht 30%, HD for 121 +/- 35 mo. At the onset and after 6 years of follow up patients underwent the following examination: length, body weight, body mass index, body fat stores, arm muscle circumference and total serum protein, serum albumin, lymphocyte count, creatinine, urea, cholesterol and PTH. In EPO group mean BMI, body fat, arm muscle circumference, visceral protein and total lymphocyte count were not change.

[The effect of long term erythropoietin treatment on levels of free amino acids in patients with long term hemodialysis].

In order to assess the effect of erythropoietin (Epo) treatment on amino acids profile in hemodialysis patients (HD pts) 2 groups of pts were analyzed: I-12 pts HD for 146 +/- 71 months, Epo treated for 64 +/- 10 months, II-17 pts HD for 120 +/- 39 months, non Epo treated, mean Hb 11.5 +/- 1.2 g/dl.

[Effect of recombinant human erythropoietin on kinetics of alloantibodies in patients awaiting renal allograft].

Iterative transfusions are one of the most important mechanism of the induction as well as maintenance anti-HLA antibodies. We evaluated the evolution of PRA (panel reactive antibodies) in 46 sensitized patients during and after withdrawal of blood transfusion. Twenty nine of them (22 women and 7 men in age 38 +/- 7 years) were treated with EPO for 13 to 60 months.

A case of severe anti-neutrophil cytoplasmic antibody (ANCA)-positive crescentic glomerulonephritis and asymptomatic gastric cancer.

A 64-year-old man presented with symptoms of systemic immune disease dominated by rapidly progressive glomerular injury with highly positive ANCA of cytoplasmic distribution. The clinical course was characterized by dependence upon the intensity of immunosuppression, which has finally led to development of fungal septicaemia and death. The post mortem examination revealed occult gastric cancer with regional lymphatic involvement and crescentic glomerulonephritis, while failing to substantiate clinical findings of systemic vasculitis.

[DNA metabolism in lymphocytes of patients with lupus nephropathy].

DNA metabolism in lymphocytes was evaluated in patients suffering from the nephrotic syndrome decompensation, basing on measurement of endonucleases (DNases) activity in these cells. The examination involved 17 patients, aged 27.7 +/- 7.

Is an increase of deoxyribonucleases activity in uraemic lymphocytes caused by their augmented synthesis in these cells?

Deoxyribonucleases activity in T and B lymphocytes isolated from 45 patients with chronic renal failure and 30 control subjects was measured. The results obtained clearly show a dramatic increase in enzyme activity in both T and B lymphocyte cells isolated from uraemic patients when compared with the control cell. The increase in enzyme activity was limited to the group of relatively small nucleases ranging from 14 kDa to 18 kDa.

DNA-dependent RNA polymerase enzymes affected in uraemic lymphocyte cells.

The DNA-dependent RNA polymerase activity and endonucleases in uraemic lymphocyte cells were investigated. It was found that the activity and quantity in three classes of polymerases are remarkably reduced. The reduction in enzyme activity is accompanied by increasing endonuclease activity.

Increase in deoxyribonuclease activity in uraemic lymphocytes is caused by the cleavage of the largest polymerase I subunit.

Deoxyribonucleases and DNA-dependent RNA polymerase activities in T and B lymphocytes isolated from patients with chronic renal failure and control subjects were studied. The data clearly shows that the nuclease activity in T and B cells isolated from uraemic patients is remarkably enhanced when compared to the control cells. Concomitant with the enhancement in enzyme activity, the reduction in RNA polymerase I activity and quantity was observed.

Uraemic lymphocytes: analysis of their nuclease activity.

The nuclease activity in T and B lymphocytes isolated from patients with chronic renal failure and control subjects was studied. The data obtained show a slight increase in nuclease activity in T and B cells isolated from uraemic patients as compared to the control cells. The increase in enzyme activity was limited to the group of relatively small nucleases with molecular weights ranging from 14 kDa to 18 kDa.

[Effect of ACE inhibitors on proteinuria and renal functioning in primary glomerulopathies].

Angiotensin converting enzyme inhibitors was given to 16 patients with glomerular nephritis in whom a complete remission of nephrotic syndrome could not be achieved with immunosuppressive-anti-inflammatory therapy. Captopril in the daily dose of 25-75 mg and enalapril in the daily dose of 10 mg were administered for 1-36 months (mean 12.6 months).